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COMPREHENSIVE TRAIL MAKING TEST

QUESTIONS

Thoughts on the CTMT?

Any other limitations?

Has anyone seen a trail making test before?

NADINE OVERHOFF

REFERENCES

CLIENT POPULATION

Allen, D. N., Haderlie, M., Kazakov, D. & Mayfield, J. (2009). Construct and Criterion Validity of the Comprehensive Trail Making Test in Children and Adolescents with Traumatic Brain Injury. Child Neuropsychology, 15, 543 – 553.

Reynolds, C. R. (2002). Comprehensive trail-making test. Austin, Texas: Pro-ed.

Smith, S. R., Servesco, A. M., Edwards, J. W., Rahban, R., Barazani, S., Nowinski, L. A., Little, J. A., Blazer, A. L. & Green, J. G. (2008). Exploring the Validity of the Comprehensive Trail Making Test. The Clinical Neuropsychologist, 22, 507 - 518.

WHAT IS THE CTMT?

DISCLAIMER

  • Individuals aged 11-74
  • Known or suspected to have an impairment of the higher cognitive processes of the brain (TBI, stroke, developmental disorder, disease, etc.)
  • Have to be able to recognize letters, words, and numbers, have fine motor skills, and have adequate visual acuity
  • A neuropsychological assessment used for detecting brain compromise and tracking progress in rehabilitation.
  • A descriptive and evaluative tool.
  • A standardized set of 5 visual search and sequencing tasks (called trails). The client is asked to connect a series of stimuli in a specific order in the fastest amount of time as possible.
  • Results of the assessment are based on the client's speed in completing the different trails.
  • The test is no longer available for purchase
  • The school did not have any copies of the tool so the trails were drawn by hand

CTMT

CLINICAL UTILITY

Overview

GREAT

  • No formal training required
  • Easy to administer and score
  • Quick (5-12minutes)
  • Little equipment is required
  • Relatively inexpensive ($79 for the manual and $67 for 10 scoring sheets)

PSYCHOMETRIC PROPERTIES

Disclaimer

Introduction

Client Population

Psychometric Properties

Clinical Utility

Reliability:

  • Internal Consistency: Cronbach's alpha 0.90
  • Observer Reliability: composite index of all 5 trails is r=0.99
  • Test-Retest: r=0.84

Demonstration

Scoring

Results

Similar Assessments

Limitations

Discussion

SCORING

Validity

  • No information on content validity
  • Construct validity (specifically convergent validity): strong correlation with tests that measure perceptual organizational ability, processing speed, sustained attention, and motor function. Strongest correlation was between the CTMT and the Wechsler Index scores.
  • Raw scores (the time) for each trail are transferred into T-scores and percentile rankings as well as a descriptive rating
  • Determine the composite index of the five different trails from the sum of the T scores
  • Plot the results into a graph for a visual representation
  • Optional calculation of significance which allows the therapist to compare scores to see if there is a significant difference between scores on the different trails
  • It can be prorated if not all of the trails were completed

MEANING OF RESULTS

  • Tool in helping to determine neuropsychological brain function
  • Design a treatment program
  • Compare results to determine treatment outcomes

SIMILAR ASSESSMENTS

DEMONSTRATION

  • Color Trail Test
  • Original Trail Making Test
  • MOCA (Montreal Cognitive Assessment)

LIMITATIONS

Laura had a car accident 12 months ago which resulted in moderately severe head trauma and a fractured pelvis. She has been referred to OT to determine suitability to return to work as a pipe fitter. Laura denies any difficulties although the family reports that she is having behavioural and cognitive difficulties - short bursts of temper, lack of concentration and attentiveness, and difficulties following directions. She has no obvious motor problems.

At our last meeting we agreed to do the Comprehensive Trail Making Test today.

  • No longer available for purchase
  • There can be no distractions. Any distraction can impact the results of the assessment.
  • Cultural biases (some cultures do not recognize our symbols of numbers)
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